脑静脉窦血栓的临床诊治分析

Clinical and Imaging Features and Treatment of Cerebral Venous Sinus Thrombosis in 17 Cases

目的:探讨颅内静脉窦血栓(CVST)形成的病因、临床表现、影像学特点及治疗方法。方法:回顾分析17例CVST患者的临床资料、影像学特点和治疗方法。结果:CVST早期诊断明确后应用抗凝、溶栓治疗,效果佳;各种溶栓治疗中,静脉窦内介入治疗血管再通率最高,其中显效11例;有效5例;死亡1例。结论:对于急性发病的有颅内高压表现,头部CT高度怀疑脑CVST患者,及时行MRI+MRV等检查,必要时行DSA检查,确诊后应尽早抗凝、溶栓治疗,和静脉窦内介入接触性溶栓血管再通率高。

Objective： To investigate the clinical and imaging characteristics of cerebral venous sinus thrombosis（CVST）, as well as to study the causes and treatments of CVST, Methods：The clinical and neuroradiologieal findings of 17 cases with CVST were analyzed retrospectively. Results：Different etiological factor could cause CVST. Clinical manifestations were unspecific showed, such as headache, nausea, vomit, disability of limbs action, consciousness disorders, epilepsy when it was in acute or subacute situations in most CVST cases. Thombosis of cerebral venous sinus was its imaging feature. Antleoagulation and thrombolysis treatment could get a good prognosis as quickly as we could after diagnosis. In our 17 cases, 11 cases recovered, 5 cases were better. 1 died. Conclusion： To acute intraeranial hypertension patients. CT scan could provide clue of CVST. MRI and MRV examination could provide diagnosis earlier, perform DSA if necessary. Antieoagulation and thrombolysis treatment by urokinase and Low Molecular tteparin should be performed as quickly as we can after diagnosis. Thrombolysis by intervention could get a better rate of revasculanzauon.